Understanding the Challenges of Readiness for Hospital Discharge in Stoma Patients: A Mixed-Methods Study

Liying Lin; Jianwei Zheng; Zhenglong Lin; Huimin Xiao

doi:10.1111/jocn.17654

Understanding the Challenges of Readiness for Hospital Discharge in Stoma Patients: A Mixed-Methods Study

J Clin Nurs. 2025 Jan 14. doi: 10.1111/jocn.17654. Online ahead of print.

Authors

Liying Lin^{1

2}, Jianwei Zheng³, Zhenglong Lin¹, Huimin Xiao^{1

4}

Affiliations

¹ School of Nursing, Fujian Medical University, Fuzhou, China.
² Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
³ Department of Oncology, The Union Hospital Affiliated With Fujian Medical University, Fuzhou, China.
⁴ Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China.

PMID: 39809578
DOI: 10.1111/jocn.17654

Abstract

Aim: To identify key factors influencing readiness for hospital discharge and delve into the experiences of stoma patients regarding their discharge.

Design: A mixed-methods study.

Method: A total of 374 colorectal cancer patients with stomas were involved to assess discharge readiness and its influencing factors. Additionally, 28 stakeholders-comprising surgeons, nursing managers, surgical nurses, enterostomal therapists, stoma patients and their family caregivers-participated in semistructured interviews. Data on discharge readiness, discharge teaching quality, stoma self-efficacy and social support were collected using validated scales. In-depth interviews provided further insights into discharge preparation experiences. Multivariate logistic regression analysis using IBM SPSS 26.0 and thematic analysis via NVivo 12.0 were employed for data analysis.

Results: Six variables accounted for 80% of the variance in discharge readiness: quality of discharge teaching, stoma self-efficacy, social support, age, gender and family income. Four main themes emerged: ambivalence towards discharge, insufficient preparation time, inadequate communication of discharge information and personal planning needs.

Conclusion: Discharge readiness among stomas patients is influenced by perceived discharge teaching quality, self-efficacy, social support, age, gender and family income. Insufficient preparation and poor communication hinder effective discharge information transfer. Enhanced, patient-centred discharge planning is expected to improve the transition from hospital to home.

Implications for the profession and/or patient care: To improve hospital discharge readiness and facilitate a smooth transition to family care, it is essential to implement patient-centred discharge planning.

Reporting method: Reported with the Mixed Methods Reporting in Rehabilitation & Health Sciences guidelines.

Patient or public contribution: None.

Trial registration: ClinicalTrials.gov identifier: ChiCTR2200058756. https://www.chictr.org.cn/bin/home.

Keywords: Hospital discharge; mixed‐methods study; stoma.